Strive to be a Dynamic Caregiver

Friday, January 10, 2014
Michael Horwath, EMT-P, FP-C

I’ve worked with many types of caregivers throughout my career. There was no question we were all in EMS to help people, because it sure wasn’t for the money. After all, there are much easier ways to make a living these days.

But putting the monetary aspect of the career aside, what’s painfully clear is the fact that even though we’ve all completed similar education and training, how we perform on the job can be strikingly different.

During medic school the terms “static” and “dynamic” were thrown around a lot regarding cardiology and skills testing. In this setting, “static” referred to a rhythm strip. It’s a six-second ECG rhythm strip we had to identify and treat as part of a training scenario—in essence, an EMS word problem to be looked at from an algorithmic perspective. “Dynamic” referred to real-time monitor readouts or, in the classroom setting, what the rhythm generator was spitting out at the time. These constantly moving and changing rhythms usually presented more of a challenge for the students and thus were more difficult to master.

But what if we applied those same terms to describe the type of healthcare providers we’ve become? You probably know someone who does a good job but follows the protocols like a recipe and thinks that if it isn’t in the protocol book, it won’t happen or can’t be treated. We can classify these people as “static medics.” They’re compassionate and want to help their patients, but aren’t critical thinkers. They’re limited in their capability to improvise and lack that key ability to think outside the box.

Conversely, there are providers who always think a step or two ahead and even outside the box to identify solutions and possibly mitigate problems before they start. These caregivers also embrace new technology and techniques to be on the cutting edge of their craft. These “dynamic caregivers” are EMS professionals and are the innovators. They’re up-to-date with the latest clinical information and are always striving to better themselves.

It’s well known there are no absolutes in medicine; the exception being that we’ll all die. The dynamic medic knows this and doesn’t say “That never happens” or “I can’t do that.” They don’t bring problems to the table; they offer solutions and always have back-up plans. The constant and sometimes moment-to-moment changes that can take place on any call are where these individuals thrive.

We’ve all been static providers at one time or another in our careers. More often than not, this is how the majority of people start off in the prehospital world. And that’s fine. In order to be a dynamic forward thinker, you need to have a solid foundation of experience and, more importantly, failure. After all, failure is the best teacher. I’m not suggesting every static medic is a failure, but in order to truly be at the top of your game, you must be able to think ahead and outside the box for an untraditional solution to an abstract or obscure problem or situation.

The problem with being static is that eventually you’ll be presented with a situation that, or patient who, doesn’t fit structured, black-and-white and sometimes restrictive protocols. This can occur at every expertise level, from the rookie to the seasoned veteran.

We all have the potential to make the transition from static to dynamic. Stepping out of your comfort zone can be unnerving and uncomfortable, but this is where real growth and development can start to take place.

We should strive to be a dynamic medic because they possess the ability to think critically and, ultimately, adapt. The ability to think creatively is one of the most valuable skills a medic can have. This is true for both emergent and non-emergent calls. It gives them the ability to look into a situation and search for solutions and opportunities to help their patients in any way they can. This person is as much a problem solver as they are a patient advocate—these individuals are adaptable. After all, being able to see the big picture and find alternative solutions are some of the most important skills we can develop as prehospital professionals.

However, this also requires a bit of humility and the ability to recognize limitations and when and how to ask for help. Attempting to intubate a patient six times just because you “always get the tube” is not only unacceptable behavior for any medical professional, but it can be very harmful to the patient. Knowing when to ask for help is just as important as knowing how to treat a specific disease process or injury pattern.

Some may argue that the majority of this comes with time. And for the most part, it does. You must be able to crawl before you can walk and walk before you can run. However, just being told what to do through protocol doesn’t always have the best outcome for your patients. There are always exceptions and the ability to identify these challenges will aid the rescuer in overcoming them. If you can’t identify the problem, you can’t fix it.

There are countless ways to improve upon the way you practice and interact with the unknowns that are thrown to us on every single run we respond to. Here are a handful of ways that could help you make the transition from static to dynamic, as well as from good to great:

>>Stay up-to-date on the latest medical research and industry trends. You may not always be able to implement such information into your daily practice, but having that extra knowledge will help better guide your clinical decision making. With such knowledge, you can better inform your patient about what to expect at the receiving facility and possibly mitigate some of their anxiety.

>> Work on written and verbal communication.After giving a report at the hospital or facility you transferred your patient to, ask staff members for feedback on your report, such as how you could improve or what they focus on when they receive one from EMS.

>> Foster a positive attitude. You could be the best medic on the planet, but if you have a negative attitude it will affect your work and those around you.

>> Set the example. If you want to be treated like a professional, act like one. Carry yourself in such a way that you not only show respect to yourself, but to those around you.

>>Know why you provide your treatments and how they work. Giving the answer “Because my protocol says so” doesn’t illustrate you understand the underlying physiology, just that you memorized a process. By obtaining this understanding you are demonstrating your professional commitment to both your patients and the industry.

The distinction of a static or dynamic medic is based solely on efforts and actions. It’s a conscious effort on the part of each and every prehospital professional to decide who they’re going to be.

Everyone deserves a dynamic EMS provider when they call 9-1-1. Will you be the forward-thinking dynamic medic or the paint-by-numbers, do-what-you’re-told static medic? We should all strive to be the former.